SAT0062 INCIDENCE OF STAPHYLOCOCCUS AUREUS BACTEREMIA IN PATIENTS WITH RHEUMATOID ARTHRITIS: A NATIONWIDE COHORT STUDY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 964.1-964
Author(s):  
S. Dieperink ◽  
B. Glintborg ◽  
L. B. Oestergaard ◽  
M. Nørgaard ◽  
T. Benfield ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Staphylococcus Aureus ◽  
General Population ◽  
Incidence Rate ◽  
Orthopaedic Implant ◽  
Research Support ◽  
Population Cohort ◽  
General Population Cohort ◽  
First Time

Background:Staphylococcus aureusis a frequent cause of bacteremia (SAB) associated with high mortality and morbidity. Patients with rheumatoid arthritis (RA) are at increased risk of septic arthritis and prosthetic joint infection withS. aureus.Objectives:To assess the incidence rate (IR) of first-time SAB in patients with RA and to estimate the incidence rate ratio (IRR) of SAB with a general population cohort without RA serving as the reference.Methods:Individuals with no prior history of SAB or RA were included consecutively from 31 December 1996, their 18th birthday or date of immigration, whichever came latest, and followed until first-time SAB, death, emigration or 31 December 2017, whichever came first. Information on RA diagnosis, vital status, age, sex, place of residence, comorbidities, medication and first-time SAB were achieved on an individual level through cross-linkage between five virtually complete Danish nationwide registries (Civil Registration System, National Patient Registry, Register of Medicinal Product Statistics, DANBIO rheumatology registry and the SAB database). We used Poisson regression to estimate adjusted IRRs overall and stratified by age and sex.Results:In total, 6,127,150 individuals were included of whom 34,627 individuals developed RA. In the RA cohort, 228 first-time SAB events occurred during 283,186 person years (PY) of follow-up (IR 80.5/100,000 PY) compared with 25,268 events during 87,521,120 PY of follow-up in the general population cohort (IR 28.9/100,000 PY). Median follow-up was 7.2 years (IQR 3.5-12.3) after RA diagnosis and 18.7 years (IQR 6.8-21) in the general population cohort. Individuals with RA who developed SAB were more often women, had an orthopaedic implant and had recent use of glucocorticoids compared with individuals with SAB without RA. (Table 1) IRs of SAB were higher among patients with RA compared with the general population in all age categories. The IRs increased with age and were higher in men, both in patients with RA and in the general population cohort. After adjustment, the IRR remained higher for individuals younger than 70 years with RA compared with the general population but was similar for older individuals. (Figure 1)Conclusion:In this nationwide cohort with more than 25,000 observed first-time SAB events, patients with RA younger than 70 years old had a 1.5-2 times higher incidence rate compared with the general population. The significance of anti-rheumatic treatments on risk and the prognosis of SAB in patients with RA remain to be explored.Acknowledgments:We wish to thank patient representative Pia Lüchau PedersenDisclosure of Interests:Sabine Dieperink: None declared, Bente Glintborg Grant/research support from: Grants from Pfizer, Biogen and Abbvie, Louise Bruun Oestergaard: None declared, Mette Nørgaard: None declared, Thomas Benfield Grant/research support from: Pfizer, Novo Nordisk and GSK, Frank Mehnert: None declared, Andreas Petersen: None declared, Merete L. Hetland Grant/research support from: BMS, MSD, AbbVie, Roche, Novartis, Biogen and Pfizer, Consultant of: Eli Lilly, Speakers bureau: Orion Pharma, Biogen, Pfizer, CellTrion, Merck and Samsung Bioepis

scholarly journals POS0213 20 Year Follow-Up Of Cardiovascular Event Risk In Rheumatoid Arthritis Compared To Diabetes

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 324.1-324
Author(s):  
R. Raadsen ◽  
R. Agca ◽  
A. Voskuyl ◽  
M. Boers ◽  
W. Lems ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
At Risk ◽  
Cohort Study ◽  
General Population ◽  
Incidence Rate ◽  
Cardiovascular Event ◽  
Survival Curve ◽  
Cvd Risk ◽  
Event Risk

Background:Patients with rheumatoid arthritis have an increased risk for developing cardiovascular diseases (CVD) compared to the general population, similar to the CVD risk in patients with diabetes mellitus. However, there are no controlled studies investigating the incidence of cardiovascular (CV) events in RA patients with follow up of more than 20 years.Objectives:The objectives of the current study were to investigate the incidence rates of CV events in a long-term follow up cohort of RA patients, and to compare these to a similar cohort representing the general population, ie. The Hoorn study.Methods:The CARRÉ study is an ongoing prospective cohort study, which started in 2001, investigating CV mortality and morbidity in 353 randomly selected patients with RA. Primary endpoints, i.e. verified medical history of coronary, cerebral or peripheral arterial disease, were determined at baseline, and after three, ten, fifteen and twenty years of follow up. Patients were censored at the date of an experienced CV event or their death. Incidence density rates per 100 patient years were calculated. Data were compared to results from the Hoorn study, a Dutch cohort study of glucose metabolism and other CV risk factors that began in 1989. All 2,484 participants were subject to an extensive and repeated CV screening program similar to that used in the CARRÉ study.Results:After 20 years of follow up 118 patients (33%) developed at least one CV event in the Carré group. Mean (SD) follow up time was 11 (6) years with a total of 3,500 years at risk and an incidence rate of 3.4 per 100 patient-years; this is slightly up from the figure reported at 15 years, i.e. 3.2 per 100 patient-years. A CV event-free survival curve is shown in figure 1. After 30 years of follow up, 295 participants of the Hoorn study had developed a CV event, during a mean follow up time 20 (8) years. Total time at risk was 50,000 years, with an incidence rate of 0.6 CV events per 100 patient years.Conclusion:In our cohort the incidence rate of CV events in RA patients has remained consistently high when compared with the general population, despite better control of RA inflammation in recent years. This again confirms the need for timely CVD-risk screening and management.References:[1]Agca R, Hopman L, Laan KJC, van Halm VP, Peters MJL, Smulders YM, et al. Cardiovascular Event Risk in Rheumatoid Arthritis Compared with Type 2 Diabetes: A 15-year Longitudinal Study. J Rheumatol. 2020;47(3):316-24.Figure 1.Survival curve of participants with rheumatoid arthritis. RA = rheumatoid arthritisDisclosure of Interests:None declared

Risk of developing diabetes and dyslipidemia among adolescents with bipolar disorder or schizophrenia

2013 ◽  
Vol 25 (1) ◽  
pp. 3-11 ◽  
Author(s):  
Cheryl Enger ◽  
Meghan E. Jones ◽  
Ludmila Kryzhanovskaya ◽  
Michael Doherty ◽  
Andrew T. McAfee
Keyword(s):  
Bipolar Disorder ◽  
Cohort Study ◽  
General Population ◽  
Incidence Rate ◽  
Retrospective Cohort ◽  
Claims Data ◽  
Comparison Study ◽  
Population Cohort ◽  
Hazard Ratios ◽  
General Population Cohort

Abstract The risks of developing diabetes and dyslipidemia among adolescents with schizophrenia and bipolar disorder have not been well-characterized. This study was designed to characterize these risks and compare them among adolescents in the general population. Methods: This retrospective cohort study used claims data from a large U.S. health insurer to identify adolescents (13–17 years) with claims for schizophrenia or bipolar disorder from 1997 to 2006. Adolescents without evidence of schizophrenia or bipolar disorder were randomly selected for comparison. Study outcomes were new diagnoses of diabetes and dyslipidemia. Results: We identified 17,884 adolescents with schizophrenia or bipolar disorder and 188,059 for the general population cohort. The incidence rate per 100,000 person-years of diabetes was higher in the schizophrenia or bipolar disorder cohort [424.3 (95% CI: 344.5–517.3)] than in the general population cohort (90.0 [95% CI: 79.6–101.3]). The incidence rate per 100,000 person-years of dyslipidemia was 346.4 (95% CI: 274.9–431.0) in the schizophrenia or bipolar disorder cohort and 86.6 (95% CI: 76.4–97.7) in the general population cohort. The adjusted hazard ratios of developing diabetes and dyslipidemia in the schizophrenia or bipolar disorder cohort relative to the general population cohort were 1.76 (95% CI: 1.15–2.72) and 1.66 (95% CI: 1.22–2.28), respectively. Adolescents with schizophrenia or bipolar disorder treated with antipsychotics had a higher risk of developing diabetes and dyslipidemia than those who were untreated. Conclusions: Adolescents with schizophrenia or bipolar disorder had significantly increased risks of developing diabetes and dyslipidemia compared to adolescents without these disorders.

scholarly journals Childhood neurodevelopmental markers and risk of premature mortality: Follow-up to age 60–65 years in the Aberdeen Children of the 1950s study

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255649
Author(s):  
Adele Warrilow ◽  
Geoff Der ◽  
Sally-Ann Cooper ◽  
Helen Minnis ◽  
Jill P. Pell
Keyword(s):  
General Population ◽  
Public Mental Health ◽  
Premature Mortality ◽  
Population Level ◽  
Population Cohort ◽  
Hazard Ratios ◽  
Wide Range ◽  
General Population Cohort ◽  
Cox Proportional Hazard Models

Background Individual neurodevelopmental disorders are associated with premature mortality. Little is known about the association between multiple neurodevelopmental markers and premature mortality at a population level. The ESSENCE (Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations) approach considers multiple neurodevelopmental parameters, assessing several markers in parallel that cluster, rather than considering individual diagnostic categories in isolation. Objectives To determine whether childhood neurodevelopmental markers, including reduced intellectual functioning, are associated with all-cause premature mortality. Methods and procedures In a general population cohort study (n = 12,150) with longitudinal follow up from childhood to middle age, Cox proportional hazard models were used to study the associations between childhood neurodevelopmental markers (Rutter B scale and IQ) and premature all-cause mortality. Outcomes and results The cognitive measures and 21 of the 26 Rutter B items were significantly associated with premature mortality in bivariate analyses with hazard ratios from 1.24 (95% CI 1.05–1.47) to 2.25 (95% CI 1.78–2.90). In the final adjusted model, neurodevelopmental markers suggestive of several domains including hyperactivity, conduct problems and intellectual impairment were positively associated with premature mortality and improved prediction of premature mortality. Conclusions A wide range of neurodevelopmental markers, including childhood IQ, were found to predict premature mortality in a large general population cohort with longitudinal follow up to 60–65 years of age. Implications These findings highlight the importance of a holistic assessment of children with neurodevelopmental markers that addresses a range of neurodevelopmental conditions. Our findings could open the door to a shift in child public mental health focus, where multiple and/or cumulative markers of neurodevelopmental conditions alert clinicians to the need for early intervention. This could lead to a reduction in the risk of broad health outcomes at a population level.

scholarly journals Pharmacoepidemiology of Benzodiazepine and Sedative-Hypnotic Use in a Canadian General Population Cohort during 12 Years of Follow-up

2010 ◽  
Vol 55 (12) ◽  
pp. 792-799 ◽  
Author(s):  
Scott B Patten ◽  
Jeanne VA Williams ◽  
Dina H Lavorato ◽  
Aliya Kassam ◽  
C David Sabapathy
Keyword(s):  
General Population ◽  
Population Cohort ◽  
General Population Cohort

Long-Term Mortality of Patients with Primary Immune Thrombocytopenia

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 619-619
Author(s):  
Henrik Frederiksen ◽  
Merete Lund Maegbaek ◽  
Henrik Toft Sorensen
Keyword(s):  
Platelet Count ◽  
General Population ◽  
Index Date ◽  
Population Based ◽  
Ongoing Treatment ◽  
Remission Status ◽  
Population Cohort ◽  
Comparison Cohort ◽  
General Population Cohort

Abstract Abstract 619 Introduction Morbidity and mortality are higher among patients with primary immune thrombocytopenia (ITP) than in the general population. In 1999 we reported on a population-based cohort of patients with incident primary ITP, with long and complete follow-up1. Here we report on mortality within this cohort according to remission status. We also compare mortality in this cohort with that in the general population. Methods ITP cohort A population-based cohort of all incident ITP patients was identified, consisting of patients aged > 14 years, diagnosed in any Danish hospital or outpatient clinic during the 23-year period from 1973 through 19951. The date of last follow-up was the last date on which the patient was both present at the hospital and had his/her platelet count measured. The index date was defined as the last follow-up date. General population comparison cohort For each ITP patient, we randomly identified 10 comparison cohort members matched on age, sex, and calendar year. Members of the comparison cohort were assigned the index date according to the ITP patient of which they were matched. Remission Remission criteria for ITP patients at last follow-up were defined before data were collected. Criteria for Complete Remission (CR) were ITP treatment discontinued and platelet count > 149 × 109/l. Criteria for Partial Remission (PR) were ITP treatment discontinued, increased platelet count since diagnosis, and one of the following: 1) platelet count of 100–149 × 109/l; 2) platelet count increased by at least 50% to 50–99 × 109/l; 3) platelet count increased by at least 100% to 20–49 × 109/l; or 4) platelet count increased to at least 20 × 109/l, if initial platelet count was < 10 × 109/l. All other patients, including those who were still on ITP medical treatment at last follow-up, were in the No Remission (NR) group. For the survival analyses, patients in the NR category were stratified into the following three subgroups on the basis of treatment and platelet count at last follow-up: A. No remission due to ongoing treatment, with a platelet count > 149 × 109/l; B. No remission due to ongoing treatment, with a platelet count < 150 × 109/l; or C. No remission and no current treatment. Statistical analysis We assessed survival in the ITP cohort and compared it to the general population cohort. Participants in the two cohorts were followed from the index date until emigration, death, or 1 January 2012, whichever event came first. We used the Kaplan-Meier Method to compare survival between the ITP and the general population cohorts. We used Cox regression to compare rates of mortality among ITP patients and members of the general population cohort. We estimated mortality rate ratios (MRRs) and associated 95% confidence intervals (CIs). The MRRs were adjusted for age, sex, calendar year, comorbidity, and remission status at last follow-up. Results Since diagnosis, 116 (52%) of the ITP patients died. The mortality in the ITP cohort was consistently higher than the in the general population cohort (Figure 1), with an adjusted MRR of 1.4 (95% CI: 1.2–1.8). When remission status was taken into account, ITP patients who were in the NR category due to ongoing treatment and decreased platelet counts at last follow-up had the highest mortality (Figure 2). This subgroup had adjusted MRRs of 6.3 (95% CI: 3.7–10.7) after 5 years, 9.1 (95% CI: 5.1–16.4) after 10 years, and 9.9 (95% CI: 5.4–18.1) after 20 years, compared to the general population cohort. In contrast, patients who were in the CR category at last follow-up had 5-year,10-year, and 20-year MRRs comparable to those of the general population cohort. Conclusion Both short-term and long-term mortality among adult ITP patients are elevated compared to the general population. Mortality rates are highest among patients who are on ITP treatment and remain thrombocytopenic. Disclosures: No relevant conflicts of interest to declare.

Adult-Onset Offending: A Neglected Reality? Findings From a Contemporary British General Population Cohort

2015 ◽  
Vol 61 (12) ◽  
pp. 1392-1408 ◽  
Author(s):  
Maria Sapouna
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
General Population ◽  
Life Events ◽  
Mental Health Problems ◽  
Deviant Peers ◽  
Adult Onset ◽  
Population Cohort ◽  
General Population Cohort ◽  
First Time

There is disagreement in the literature as to whether there are any true adult-onset offenders. The aim of this study is to investigate the prevalence and correlates of adult-onset offenders in a contemporary British general population cohort consisting of 739 individuals aged between 18 and 25 years. Sixteen percent of participants reported offending for the first time after the age of 18. It is concluded that adult-onset exists and deserves to be studied further. Adult-onset offenders were more likely to report using drugs, associating with deviant peers, and having mental health problems in adulthood than non-offenders. Compared with early-onset offenders, the adult-onset offenders were people with a stronger attachment to school, which may have protected them from the risk of offending in adolescence. It is possible that when that protection was removed in adulthood and they were exposed to negative life events, such as drug use and mental illness, they became involved in crime for the first time.

scholarly journals Establishing and characterising large COVID-19 cohorts after mapping the Information System for Research in Primary Care in Catalonia to the OMOP Common Data Model

2021 ◽  
Author(s):  
Edward Burn ◽  
Sergio Fernández-Bertolín ◽  
Erica A Voss ◽  
Clair Blacketer ◽  
Maria Aragón ◽  
...  
Keyword(s):  
Primary Care ◽  
General Population ◽  
Data Quality ◽  
Data Model ◽  
Common Data Model ◽  
Test Results ◽  
Patient Level ◽  
Population Cohort ◽  
General Population Cohort

Background Few datasets have been established that capture the full breadth of COVID-19 patient interactions with a health system. Our first objective was to create a COVID-19 dataset that linked primary care data to COVID-19 testing, hospitalisation, and mortality data at a patient level. Our second objective was to provide a descriptive analysis of COVID-19 outcomes among the general population and describe the characteristics of the affected individuals. Methods We mapped patient-level data from Catalonia, Spain, to the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM). More than 3,000 data quality checks were performed to assess the readiness of the database for research. Subsequently, to summarise the COVID-19 population captured, we established a general population cohort as of the 1st March 2020 and identified outpatient COVID-19 diagnoses or positive test results for SARS-CoV-2, hospitalisations with COVID-19, and COVID-19 deaths during follow-up, which went up until 30th June 2021. Findings Mapping data to the OMOP CDM was performed and high data quality was observed. The mapped database was used to identify a total of 5,870,274 individuals, who were included in the general population cohort as of 1st March 2020. Over follow up, 604,472 had either an outpatient COVID-19 diagnosis or positive test result, 58,991 had a hospitalisation with COVID-19, 5,642 had an ICU admission with COVID-19, and 11,233 had a COVID-19 death. People who were hospitalised or died were more commonly older, male, and with more comorbidities. Those admitted to ICU with COVID-19 were generally younger and more often male than those hospitalised in general and those who died. Interpretation We have established a comprehensive dataset that captures COVID-19 diagnoses, test results, hospitalisations, and deaths in Catalonia, Spain. Extensive data checks have shown the data to be fit for use. From this dataset, a general population cohort of 5.9 million individuals was identified and their COVID-19 outcomes over time were described. Funding Generalitat de Catalunya and European Health Data and Evidence Network (EHDEN).

scholarly journals O06 Baseline predictors of methotrexate-related adverse events in methotrexate-naïve patients with RA

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Ahmad A Sherbini ◽  
James M Gwinnutt ◽  
Kimme L Hyrich ◽  
Suzanne M M Verstappen ◽  
Keyword(s):  
Rheumatoid Arthritis ◽  
Adverse Events ◽  
Health Assessment ◽  
Prevalence Rates ◽  
Clinical Predictors ◽  
Research Support ◽  
Related Data ◽  
Increased Risk ◽  
One Year

Abstract Background/Aims  Methotrexate (MTX) is the most common treatment for rheumatoid arthritis (RA). The prevalence of adverse events (AEs) associated with MTX treatment for RA have been studied extensively, but there are limited data on the predictors of these AEs. This study aims to summarise the prevalence rates of MTX AEs, including gastrointestinal (GI), neurological, mucocutaneous, and elevated alanine transaminase (ALT) enzyme, and to identify baseline demographic and clinical predictors of these AEs. Methods  The Rheumatoid Arthritis Medication Study (RAMS) is a UK multi-centre prospective cohort study of patients with RA starting MTX for the first time. Relevant demographic, medication, clinical and disease related data were collected at baseline. AEs were reported at six and twelve months follow-ups. The prevalence rates of AEs were calculated based on the proportions of patients who reported having had an AE within one year of follow-up. The associations between candidate baseline predictors and AEs were assessed using multivariable logistic regression. Results  A total of 2,089 patients were included with a mean age of 58.4 (standard deviation: 13.5) years, 1390 (66.5%) were women. 1,814 and 1,579 patients completed the 6 and 12 months follow-up visits, respectively. The prevalence rates of the AEs within one year of follow-up were: GI = 777 (40.6%), mucocutaneous = 441 (23.1%), neurological = 487 (25.5%), elevated ALT (&gt; upper limit of normal [ULN]) = 286 (15.5%). Younger age and being a woman were associated with increased risk of GI AEs, (age: OR 0.97 per year increase in age, 95% CI 0.98, 1.00; male sex: OR 0.58 vs female, 95% CI 0.46, 0.74) (Table 1). Higher baseline Health Assessment Questionnaire (HAQ) score was an independent predictor of GI, mucocutaneous, and neurological AEs. Furthermore, having ALT &gt;1xULN at baseline or history of diabetes was associated with increased risk of subsequent ALT elevation during the study follow-up. Conclusion  In patients with RA starting MTX, GI AEs were the most commonly reported AEs during the first year of follow-up. The identified predictors of AEs may facilitate discussions between clinicians and patients prior to commencing MTX, and may lead to increased adherence and consequently improved effectiveness. Disclosure  A.A. Sherbini: None. J.M. Gwinnutt: Grants/research support; BMS. K.L. Hyrich: Member of speakers’ bureau; Abbvie. Grants/research support; Pfizer, UCB, BMS. S.M.M. Verstappen: Consultancies; Celltrion. Member of speakers’ bureau; Pfizer. Grants/research support; BMS.

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